| NPI | 1952789513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE ANGEL GONZALEZ Owner 956-727-2629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX 207Q00000X) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2015-05-14 |